Chong C A K Y, Diaz-Granados N, Hawker G A, Jamal S, Josse R G, Cheung A M
Division of General Internal Medicine and Clinical Epidemiology, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Canada.
Osteoporos Int. 2007 Nov;18(11):1547-56. doi: 10.1007/s00198-007-0417-x. Epub 2007 Jun 30.
UNLABELLED: We describe complementary and alternative medicine use (CAM) in 360 patients attending osteoporosis clinics. Of these patients, 57% were CAM users. Predictors of CAM use included lower mental quality of life, younger age and higher education. Less than half of CAM use was disclosed to physicians, despite potential adverse interactions. INTRODUCTION: The prevalence of complementary and alternative medicine (CAM) use in osteoporosis clinics is not known. The objective of this study was to describe the pattern of CAM use in this population. METHODS: We performed a cross-sectional study of 360 patients attending academic osteoporosis clinics in Toronto, Canada in 2001. Subjects completed a self-administered questionnaire on CAM use. Health-related quality of life (HQL) was measured with the Short-Form 36v2. Comparative statistics and logistic regression were performed to identify sociodemographic, HQL and clinical correlates of CAM use. RESULTS: More than 80% of participants were women, Caucasian and had at least a high school education. Of subjects, 57% used CAM in the previous year. Only 44% of CAM use was disclosed to a medical doctor. CAM users and non-users did not differ in clinical characteristics such as bone mineral density, level of comorbidity and fracture history. In univariate analysis, CAM users were less satisfied with conventional medicine. However, when we explored patient satisfaction, comorbidities and sociodemographic as predictors for CAM use, the multivariable analyses showed that lower mental HQL, younger age, and post-secondary education were the only significant predictors. We identified 35 cases in which the utilization of CAM supplements could possibly exacerbate existing medical conditions. CONCLUSION: Patients attending osteoporosis clinics frequently use CAM. Conceptually, the predictors of use identified in this study may fit into a socio-behavioral model that helps explain why people turn to CAM. Physicians may need to elicit a history of CAM use more vigilantly so as to better screen for possible adverse clinical interactions.
未标注：我们描述了360名就诊于骨质疏松症诊所的患者使用补充和替代医学（CAM）的情况。在这些患者中，57%使用CAM。使用CAM的预测因素包括较低的心理生活质量、较年轻的年龄和较高的教育程度。尽管可能存在不良相互作用，但向医生披露的CAM使用情况不到一半。 引言：骨质疏松症诊所中补充和替代医学（CAM）的使用 prevalence尚不清楚。本研究的目的是描述该人群中CAM的使用模式。 方法：我们于2001年对加拿大多伦多学术性骨质疏松症诊所的360名患者进行了一项横断面研究。受试者完成了一份关于CAM使用的自填问卷。使用简短健康调查简表36v2测量健康相关生活质量（HQL）。进行比较统计和逻辑回归以确定使用CAM的社会人口统计学、HQL和临床相关因素。 结果：超过80%的参与者为女性、白种人且至少受过高中教育。在受试者中，57%在前一年使用过CAM。仅44%的CAM使用情况向医生披露。CAM使用者和非使用者在临床特征如骨密度、合并症水平和骨折史方面没有差异。在单变量分析中，CAM使用者对传统医学的满意度较低。然而，当我们将患者满意度、合并症和社会人口统计学作为CAM使用的预测因素进行探索时，多变量分析表明较低的心理HQL、较年轻的年龄和高等教育是仅有的显著预测因素。我们确定了35例使用CAM补充剂可能会加重现有医疗状况的病例。 结论：就诊于骨质疏松症诊所的患者经常使用CAM。从概念上讲，本研究中确定的使用预测因素可能符合一个社会行为模型，该模型有助于解释人们为何转向CAM。医生可能需要更警惕地询问CAM使用史，以便更好地筛查可能的不良临床相互作用。
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